research updates on family treatment courts · steering . committee. management level. monthly or ....
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Research Updates on Family Treatment Courts: Overview of Best Practices – Part 2
Phil Breitenbucher, Children and Family Futures 1
This presentation is supported by:
The Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs
(2013-DC-BX-K002)
Points of view or opinions expressed in this presentation are those ofthe presenter(s) and do not necessarily represent the official positionor policies of OJJDP or the U.S. Department of Justice.
Acknowledgement
A permanent shift in doing business that relies on relationships across systems and within the community to secure needed resources to
achieve better results and outcomes for all children
and families
Systems Change
3RsRelationshipsResourcesResults
Outcomes5Rs for more families
Values – Why Are We Doing This?
A Framework for Systems ChangeRecoveryRemain in homeReunificationRecidivismRe-entry
FDC Common
Ingredients –What works…
Structural Supports1. Relationships2. Resources3. Results
Leadership at all levels
Inclusion of stakeholders
Sustainability based on outcomes and
results
Shared information about institutional
barriers
Key Components of Meaningful Systems Change
Oversight/ExecutiveCommittee
Director Level
Quarterly
Ensure long-term sustainability and final approval of practice and policy changes
Steering Committee
Management Level
Monthly or Bi-Weekly
Remove barriers to ensure program
success and achieve project’s goals
FDC Team
Front-line staff
Weekly
Staff cases; ensuring client success
Membership
Meets
Primary Functions:
The Collaborative Structure for Leading Change
Mobilizing Resources
Building Relationships
Prioritizing Results
Information flow is the lifeblood, the fuel of an effective collaborative.
Leadership consists of encouraging that flow, analyzing its meaning, and framing decisions
that the team needs to make together.
Information flow
FDC Team
Membership Primary FunctionFrequency
FDC Coordinator vs. FDC Case Manager
Key FDC Case Management Functions
Assessment
Planning
Linkage
Monitoring
Advocacy
Provide case management
Garnering community support
Prepare and manage FDC docket
Oversee budget and resources
Contract management
Grant Writing
FDC Coordinator Roles & Functions
Maintain individual client files
The FDC Coordinator - The Realities• Often work under limited direction of a manager• Responsibility-YES; Authority –MAYBE• No choice in team members• Dynamics constantly changing due to new staff, politics, funding• May involve frequent and relatively independent working relationships• May assume leadership at various points of development process or life
span of FDC • Oftentimes grant-funded positions and are cut due to budgetary issues• Partners’ resource limitations• May oversee other collaborative court programs
One person expecting to be all things to all people
Oversight/ExecutiveCommittee
Director Level
Quarterly
Ensure long-term sustainability and final approval of practice and policy changes
Steering Committee
Management Level
Monthly or Bi-Weekly
Remove barriers to ensure program
success and achieve project’s goals
FDC Team
Front-line staff
Weekly
Staff cases; ensuring client success
Membership
Meets
Primary Functions:
The Collaborative Structure for Leading Change
Information Flow
Steering Committee
Membership Primary FunctionFrequency
Effective Steering Committees is more than reporting about what agencies did last month—it’s about whether clients are doing better.
Busting barriers for improved outcomes
Effective leaders approach barrier-busting as a norm; they don’t take barriers for granted
They know the difference between barriers and excuses
- Confidentiality won’t let us share information- Other agencies don’t understand our clients- Our funders won’t let us do it- We don’t have the funding to take our efforts to scale
Barrier Busters
Innovative
@ the table means:- More than signing an MOU- Key agencies are not just “sending
somebody;” they are actively engaged- Involved in policy and operation
decisions- Knows where the money is going
Who’s Missing @ the Table
Effective leaders invest and help build capacity of each partner, particular missing partners, to better serve families.
Remember - you are only as strong as your weakest link
Builds Up Weakest Links
Collaborative
Beware!
Marginalized Collaborative
Ahead!
Warning Signs of Powerless Partnerships
Warning Signs of Powerless Partnerships• Monthly BOGSATs* reporting only on activities, not results
‒ Reporting on what agencies are doing, not whether clients are doing better
• No buy-in at policy levels, only mid-level staff involved• No buy-in at front-line levels: all supervisors without staff who have
regular contact with families• Missing players, too-dominant conveners, absent handoff agencies,
over-reliance on a “coordinator”• Undue focus on one set of links—training, referrals, info systems—
without looking at the whole system
*Bunch of guys sitting around a table
Develop Interagency Partnerships#2
Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approachKey Component 10: Forging partnerships
FDCs bring together the legal framework of court, child welfare system and treatment services in a collaborative relationship with a common goal: to restore families. To best achieve this goal, however, they must collaborate with other agencies to provide the range of services and support required to ensure family stability, recovery of parents, and the permanent placement, safety and well-being of children. These partners should include mental health, domestic violence, primary health care, child development and other agencies.
Develop Interagency Partnerships
Routinely Assess for Rates ofReferrals, Completions & Barriers
Somewhat Agree
Agree
Responses (n = 26)
Disagree
Don’t Know:26.9%
Drug Courts That Required All Team Members to Attend Staffings
Had 50% Greater Reductions in Recidivism and 20% Greater Savings
0%
10%
20%
30%
40%
50%
All team members attend staffingsN=31
All team does NOT attend staffingsN=28
42%
28%
Perc
ent r
educ
tion
in re
cidi
vism
Note 1: Difference is significant at p<.05Note 2: “Team Members” = Judge, Both Attorneys, Treatment Provider, Coordinator
Note: Difference is significant at p<.10
Drug Courts Where a Representative from Treatment Attends Court Sessions
Had 81% Higher Cost Savings
Yes (N=55) No (N=9)
29%
16%
A Representative from Treatment Attends Court Sessions%
incr
ease
in c
ost s
avin
g
0%
10%
20%
30%
Defense attorney attends staffingsN=59
Defense Attorney does NOT attend staffingsN=11
29%
15%
Perc
ent I
ncre
ase
in C
ost S
avin
gs
Drug Courts Where the Defense Attorney Attends Drug Court Team Meetings (Staffings) had
a 93% Higher Cost Savings
Note: Difference is significant at p<.0528
WHO needs to know WHAT,
WHEN?
http://www.ncsacw.samhsa.gov/files/SAFERR.pdf
Resource: Screening and Assessment for Family Engagement, Retention, and
Recovery (SAFERR)
To download a copy, please visit:
Create Effective Communication Protocols for Information Sharing#3
Key Component 1: Integrate treatment services with justice system case processing Key Component 2: Using a collaborative approachKey Component 6: Responses to behaviorKey Component 7: Judicial Interaction
Effective, timely and efficient communication is required tomonitor cases, gauge FDC effectiveness, ensure jointaccountability, promote child safety and engage and retainparents in recovery.
Create Effective Communication Protocols for Sharing Information
0%
10%
20%
30%
40%
50%
60%
70%
Agree Somewhat Agree Disagree Not Sure
Responses (n = 26)
The FTC has developed the capacityto automate data about theoutcomes of the participants
compared to the larger systems
The FTC utilizes community-wideaccountability systems to monitor childwelfare issues with specific indicators
Somewhat Agree
Agree
Responses (n = 26)
Disagree
Don’t Know:34.6 %
Create Effective Communication Protocols for Sharing Information
Don’t Know:53.9 %
0%
10%
20%
30%
40%
Program usespaper files
N=8
Program haselectronic database
N=3
20%
33%
Perc
ent i
ncre
ase
in c
ost s
avin
gs
Drug Courts That Used Paper Files Rather Than Electronic Databases Had
65% LESS Savings
Note: Difference is significant at p<.05
Note: Difference is significant at p<.05
Drug Courts where all team members attended staffings had 50% greater reductions in recidivism
0%
10%
20%
30%
40%
50%
All team members attend staffingsN=31
All team does NOT attend staffingsN=28
42%
28%
Perc
ent r
educ
tion
in re
cidi
vism
Note: Difference is significant at p<.10
Drug Courts Where Treatment Communicates withthe Court via Email had
119% greater reductions in recidivism
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
YesN=31
NoN=14
0.46
0.21
% re
duct
ion
in #
of r
earr
ests
Treatment communicates with court via email
Note: Difference is significant at p<.05
0%
10%
20%
30%
40%
Drug tests are back within48 hours
N=21
Drug testsare back in
LONGER THAN48 hours
N=16
32%
19%
Perc
ent i
ncre
ase
in c
ost s
avin
gs
Drug Courts Where Drug Test Results are Back in 48 Hours or Less had
68% Higher Cost Savings
Ensure Cross-Systems Knowledge
Ongoing cross‐training of FDC team members andstakeholders at all levels is essential for ensuringcollaboration and consistent, effective practice.
#4
Key Component 9: Continuing interdisciplinary education
Note: Difference is significant at p<.05
Drug Courts That Provided Formal Training for ALL New Team Members
Had 54% Greater Reductions in Recidivism
0%
10%
20%
30%
40%
50%
All new teammembers have formal training
N=30
All team membersNOT formally trained
N=17
40%
26%
Note: Difference is significant at p<.05
Drug Courts That Received Training Prior to Implementation Had Almost
3.5 Times Higher Cost Savings
0%
10%
20%
30%
40%
Team trained BEFORE implementationN=12
Team members NOT trained beforeimplementation
N=5
27%
8%
Perc
ent i
ncre
ase
in c
ost s
avin
gs
Cross-Systems Knowledge –Training on Operations
10091
0102030405060708090
100
Training on RPG OperationsFDC Cohort (N=20) All Other RPGs (N=35)
Perc
ent
* Includes meetings to discuss program and policy and/or management or administrative issues
Oversight/ExecutiveCommittee
Director Level
Quarterly
Ensure long-term sustainability and final approval of practice and policy changes
Steering Committee
Management Level
Monthly or Bi-Weekly
Remove barriers to ensure program
success and achieve project’s goals
FDC Team
Front-line staff
Weekly
Staff cases; ensuring client success
Membership
Meets
Primary Functions:
The Collaborative Structure for Leading Change
Information Flow
Oversight|ExecutiveCommittee
Membership Primary FunctionFrequency
Implement Funding & Sustainability Strategies#9
Key Component 9: Continuing interdisciplinary education
Key Component 10: Forging partnerships
Sustainability planning must address financial needs as well as support from a broad range of stakeholders. FDCs must have access to the full range of funding, staffing and community resources required to sustain its innovative approaches over the long term. FDCs need a governance structure that ensures ongoing commitment from policy makers, managers, community partners and operational staff members.
Budget and Sustainability – Barriers and Challenges• Need for ongoing champions; challenge with turnover of
judges• Some FDTCs operate as “projects” or “boutique courts” (on
top or on the side)• Inherent limitations on scale and scope in some FDC models• No standardized cost analysis of total program cost or cost
savings• Lack of sufficient data on program effectiveness• Resource problems worsened by State and local fiscal crises
Implement Funding and Sustainability Strategies
0%
10%
20%
30%
40%
50%
Agree Somewhat Agree Disagree Not Sure
Responses (n = 26)
Funding and Sustainability Efforts
The FTC has a community outreach andeducation plan to further sustainability
efforts
The FTC's partners are able and willing toshare information about their budget and
staffing
Somewhat Agree
Agree
Responses (n = 26)
Disagree
Don’t Know: 42.3 %
Don’t Know:30.7 %
Sustainability Results
73.2 % of the major services and
activities provided as part of the grant were sustained
53.3 % sustainedspecific components or a scaled down or modified version of their program
model
33.3 %sustained their project in its
current form or modelbeyond their grant period
11.1% were not able
to sustain any of their program
Of the 44 regional partnerships whose
grants were not extended:
Redirection of Resources Already Here
Substance Abuse
TANF
Domestic Violence
HospitalsSchools
Police
Medicaid
Housing
MentalHealth
Courts
Families
FDCs
Pilots, Demos and Grant-funded Projects
The “Real” Resources
in the Community
Potential Funding for Expansion
Federal Direct Funding (FY 2012): $22.6 million
$13.6 billionPrimarily Title IV-E, TANF, SSBG, Medicaid, IV-B
$350 billionChildren’s Programs - (Urban Institute, 2012)
Successful Financing StrategiesWidening the definition of available or potential resources Connecting with other related grants or initiatives
Changing the business as usual practices to incorporate RPG innovations Incorporating RPG efforts within their own agency
Integrating with other child welfare systems improvements
Transitioning services and staff to other partner organizations
Negotiating third party payments for what the grant had initiated
Joining with larger health care reform and care coordination efforts
Institutionalizing RPG practices into existing systems of care Third-party billing, Medi-caid
Redirecting existing, currently funded resources to adopt new case management and client engagement strategies
Collaborative Practice Implications
What do substance abuse and mental health treatment practitioners need from child welfare staff to more effectively assess and treat parents and children?
What do child welfare staff need from substance abuse and mental health treatment practitioners to more effectively make decisions about the safety, permanence and well-being of children they are charged to protect?
Effective leaders have wide-lens radar: • See external policy context;
parallel/competing initiatives• Know they’re not the only
game in townWide-Lens View
Systems-Focused
Distributive
Effective leaders sell the results of collaboration to other leaders
Demand the data to make the sale
Outcome-focused
Characteristics of collaborative leadership IILeaders know that nothing collaborates like cash—but it takes more than resources to make it real and to take it to scale
Limits of Cash
Garner Community Support
FDCs collaborate with community‐based organizations tosupport the multiple needs of parents, children andfamilies during FDC participation, and to provide ongoing support for continued success after family members have completed their FDC services.
#8
Key Component 10: Forging partnerships
To develop marketing documents, consider these elements in building your case:
• Prevalence of the problem
• Outcomes
• Case savings
• Intergenerational impact
• Early intervention and developmental effects on children
Making the Case in the Community
• How does parental substance use and child maltreatment effect other, high-priority issues?
• Are we clear on the benefits of your FDC?
• Have we done an inventory of potential funders? Have we begun a dialogue with those funders?
• Have we packaged the strongest possible case for our FDC? Do we use both stories and numbers to make the case?
• Have we documented how we’ve already changed the system and changed the rules?
• Who’s going to tell our story: who’s singing our song?
Making the Case in the Community
• What type of strategies have been developed to recruit broad community participation in addressing the needs of participant families?
• Do participant families have an active role in planning, developing, implementing and monitoring services?
• Do you include community stakeholders in planning and program development?
• Have you conducted a needs-assessment of FDC participants?
• How do you identify and link families with support services they need?
• Do you keep the community aware of your efforts and outcomes?
• Which policy leaders and stakeholders agree that funding is a priority in the midst of all the competing options for use of scarce resources?
Garnering Community Support
Note: Difference is significant as a trend at p<.15
Drug Courts That Had Formal Partnerships with Community Organizations Had
More Than Twice the Savings
0%
10%
20%
30%
40%
Drug court has formal partnerships in communityN=15
Drug court doees NOT have formal partnershipsN=5
35%
15%
Collaborative Practice ImplicationsWhat system changes need to occur to support local, cross-system collaborative practices? • Priority and timely access to treatment• Address confidentiality• Abstinence vs. Harm Reduction • Systems’ response to relapse• Enhanced acceptability of MAT• Cross-Systems Training• Engagement of Court and Attorneys
Evaluate Shared Outcomes to Ensure Accountability
FDCs must demonstrate that they have achieved desiredresults as defined across partner agencies by agreeing ongoals and establishing performance measures with theirpartners to ensure joint accountability. FDCs developand measure outcomes and use evaluation results to guidetheir work. FDCs must continually evaluate their outcomes and modify their programs accordingly toensure continued success.
#10
Key Component 8: Monitoring and Evaluation
Oversight/ExecutiveCommittee
Director Level
Quarterly
Ensure long-term sustainability and final approval of practice and policy changes
Steering Committee
Management Level
Monthly or Bi-Weekly
Remove barriers to ensure program
success and achieve project’s goals
FDC Team
Front-line staff
Weekly
Staff cases; ensuring client
success
The Collaborative Structure for Leading Change
Primary Functions:
Meets
Membership
Information Flow
The Community
Collaboration =
Shared results =
Accountability =
Trust that PromotesSustainability
Evaluate for Shared Outcomes and Accountability
The FTC has an ongoing plan forevaluation
Somewhat Agree Agree
Responses (n = 26)
Disagree
Don’t Know:30.77 %
Note: Difference is significant at p<.05
Program reviews their own statsN=20
Program does NOT review statsN=15
37%
16%
Perc
ent i
ncre
ase
in c
ost s
avin
gs
Drug Courts Where Review of The Data and Stats Has Led to Modifications in Drug
Court Operations had a 131% Increase in Cost Savings
Note: Difference is significant at p<.05
0%
10%
20%
30%
40%
50%
Used evaluation to make modifications toprogram
N=18
Did NOT use evaluation to make modificationsN=13
36%
18%
Perc
ent i
ncre
ase
in c
ost s
avin
gs
#2 Drug Courts Where the Results of Program Evaluations Have Led to
Modifications in Drug Court Operations Had a 100% Increase in Cost Savings
Five Diagnostic Questions about Collaboration1. Do we agree on the mission?2. Do we agree on how we are going to measure whether we are
achieving the mission—do we have a way of tracking progress (i.e. data dashboard)
3. When front-line staff raise issues about barriers they run into—do we ignore it or go to work as a team to reduce or remove the barriers?
4. Do we share enough information across agencies to be able to use our results to get more resources for what is working?
5. Do we have an agenda for scaling up—or are we stuck in projectitis?
Q&A and Discussion
Building on our Success
TEAM ACTION PLANNING Building Structure to Implement and Sustain Your Program
71
Resources
http://www.ncsacw.samhsa.gov/files/SAFERR.pdf
Resource: Screening and Assessment for Family Engagement, Retention, and
Recovery (SAFERR)
To download a copy, please visit:
FDC Guidelines
http://www.cffutures.org/files/publications/FDC-Guidelines.pdf
To download a copy today visit our website:
FDC Discipline Specific Orientation Materials
Child Welfare | AOD Treatment | Judges | Attorneys
Please visit: www.cffutures.org/fdc/
Resources
FAMILY DRUG COURTPEER LEARNING COURT
PROGRAM
King County, WA
Baltimore City, MDJackson County, MO
Chatham County, GAPima County, AZ
Wapello County, IA
Miami-Dade, FL
Jefferson County, AL
Dunklin County, MO
CONTACT US FOR MORE INFORMATION: [email protected]
• FDC Peer Learning Court
• FDC Podcasts
• Leadership Resources
• FDC Video features
• Webinar registration information
FDC Learning Academy BlogLeading Change
www.familydrugcourts.blogspot.com
2016
1. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers
2. Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals
3. Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals
Please visit: http://www.ncsacw.samhsa.gov/
NCSACW Online Tutorials
Resources
Family Drug Court Online Tutorial
FDC 101 – will cover basic knowledge of the FDC model and operations
Contact InformationPhil Breitenbucher, MSW FDC TTA Program DirectorChildren and Family Futures(714) [email protected]